How to Breathe Correctly for Optimal Health, Mood, Learning & Performance

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology at Stanford school of medicine today we are discussing breathing now breathing is something that we are all familiar with because frankly we are all doing it right now and we do it during our waking States and while we are asleep and most of us have probably heard that breathing is essential to life we hear that we can survive without food for some period of time maybe even up to a month or more that we can't survive that long without water but we could survive a few days without water depending on how well hydrated we are when we go into that water deprivation and the Heat of the environment we happen to be in but that we cannot survive without breathing for more than a few minutes and that if we cease to breathe that our brain and our bodily tissues will die and in fact that is true however despite everybody's knowledge that breathing is essential to life I don't think that most people realize just how important how we breathe is to our quality of life and that includes our mental health our physical health and what we call Performance that is our ability to tap into skills either physical or cognitive in ways that we would not be able to otherwise if we are not breathing correctly so today we are going to talk about what it is to breathe correctly both at rest during sleep in order to reduce our levels of stress in order to wake up or to become more alert deliberately and many many other things including how to stop hiccuping this is one of the most search for topics on the internet today I will teach you the one method that is actually linked to science no it does not involve drinking a glass of water backwards from the opposite side of the cup or holding your breath in any kind of esoteric way it actually relates to the neural mechanisms that is the brain to- body connections that cause the hiccup hiccup is a spasm of that neural circuit and I'll teach you how to turn off that neural circuit in one try and that's not a technique I developed it's a technique that's actually been known about for several centuries and we now know the underlying mechanism so today's discussion will give to you many tools that you can apply all of these tools are of course behavioral tools they're completely zero cost and in telling you how those tools work you'll learn a lot about how the breathing aka the respiratory system works and how it interfaces with the other organs and tissues of the body in particular the brain in fact one of the most important things to understand about breathing right here at the outset is that breathing is unique among brain and bodily functions in that it lies at the interface between our conscious and our subconscious behavior and it represents a bridge literally in the brain between the conscious and the subconscious what do I mean by that well breathing does not require that we pay attention to our breathing or that we are even aware that we are breathing it will just carry on in the background either normally or abnormally and I'll teach you what Normal and abnormal breathing is in a little bit however breathing is unique among brain and bodily functions in that at any moment we can consciously take control of how we breathe this is an absolutely spectacular and highly unusual feature of brain function for instance your digestion is carrying on in the background right now whether or not you've had food recently or not but you can't simply control your digestion by thinking about it in a particular way in fact most people can't even control their Thinking by trying to control their thinking that actually takes some practice it can be done topic for a future episode however breathing is unique breathing will carry on involuntarily subconsciously in the background as I said before but if at any moment you want to hold your breath or inhale more deeply or vigorously or exhale longer than you inhale you can do that very few if any other neural circuits in your brain and body allow that level of control and turns out that level of control is not an accident it has been hypothesized that by controlling breathing the brain is actually attempting to control its own state of mind now the way this was originally stated in a scientific research paper was a little bit different it was a little bit more physiological the statement was the brain by regulating breathing controls its own excitability excitability in the context of neurobiology is how able the brain is to take in new information or not how able the brain is or not to turn itself off to go to sleep and to regulate its own levels of anxiety Focus Etc if that seems a little bit abstract I'll make it simple for you by changing your pattern of breathing you can very quickly change what your brain is capable of doing in fact a little bit later I'll tell you that while you inhale you are far better at learning and remembering information than during an exhale and it is a very significant difference does that mean you should only inhale and not exhale no of course not I'll teach you how to breathe for the sake of learning and memory as well as for physical performance and a number of other things so hopefully I've been able to highlight for you the importance of breathing not just for life because yes breathing is essential for life but that the subtleties of how we breathe the duration and intensity of our inhales and our exhales how long we hold our breath between inhales and exhales very critically defines our state of mind and our state of body what we are able to do and what we are not able to do and the great news is we can control our breathing and in doing so control our mental health physical health and performance before we begin I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford it is however part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme I'd like to thank the sponsors of today's podcast our first sponsor is hvmn hvmn which is a supplement that increases ketones can be used in the context of a ketogenic diet however many people including myself find that increasing blood ketones by using a supplement such as hvmn can greatly improve cognitive ability and physical output for mental work and for exercise even when not on a ketogenic diet there's a lot of research supporting the fact that even if you are consuming carbohydrates and you are not in ketosis that is you are not following a ketogenic diet consuming supplements that can increase blood ketones can allow you to think more clearly for cognitive work and physical work for that matter perform at greater output for things like resistance training and endurance exercise and indeed that's what I found 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advisory Council to help whoop evolve their mission to improve the way that people are sleeping and thereby to improve their levels of focus mood and alertness and performance in all Endeavors during the day as a whoop user I've experienced the health benefits the focus benefits essentially all of the major benefits that come with getting an excellent night's sleep on a consistent basis I've also learned from using my whoop how certain daily activities like the timing of exercise caffeine and a number of other things in impact the depth quality and duration of my sleep is one of those tools that can really help guide you and provide you with personalized data recommendations and coaching around your body and your overall health so it's not just about tracking sleep it's about tracking all aspects of your activity and health and of course including sleep if you're interested in trying whoop you can go to join. woop.com huberman today and get your first month free let's talk about breathing and of course we breathe in order to bring oxygen into the body but we also breathe to remove certain things from our body in particular carbon dioxide so the main players in today's discussion are going to be oxygen and carbon dioxide now a common misconception is that oxygen is good and carbon dioxide is bad that's simply not the case let's just take a step back from that statement and let's think about this when we breathe in we are largely breathing in air in order to bring oxygen into our body and we can just stop right there and say why do we breathe at all why can't we just get oxygen from the world around us well it's because oxygen can't diffuse through our skin into the deeper cells of our body other single cell and very simple organisms can actually bring oxygen into their system without the need to breathe but we have to breathe in order to bring oxygen to the cells that reside deep in our body in particular our brain cells which are the most metabolically active cells in our body require a lot of oxygen and those brain cells are sitting of course in the brain which is encased in the cranial Vault the skull and so oxygen can't simply pass to those cells so we need to have a system that will deliver oxygen to those cells we also need a system which turns out to be the breathing or respiratory system that can offload or remove the gas that we call carbon dioxide not because carbon dioxide is bad but because too much of it in our system is not good in fact much of today's discussion will also center around the common misconception that carbon dioxide is something that we want to get rid of you don't want want to get rid of too much carbon dioxide or else you can't actually get oxygen to the cells and tissues of your body in an efficient way so you need oxygen and you need carbon dioxide in your body you also need to be able to offload or remove carbon dioxide and bring in oxygen in the correct ratios so that you can perform the kind of mental functions and physical functions that you want to so if we just dial out even further we say what are the key components of breathing what are the elements within the body that allow us to bring oxygen to the tissues and cells as is required and remove carbon dioxide from the body as is required and yet keep enough carbon dioxide around in order to allow oxygen to do its thing well that breathing or respiratory apparatus has two major components and I'm going to just briefly describe those and as I do this I really want to highlight the fact that anytime you're thinking about biology and Physiology in particular whether or not it's about the brain or the liver or the gut microbiome it's useful to categorize things either as mechanical mechanisms or chemical mechanisms what do I mean by that well let's just take the analogy of hunger there are mechanical mechanisms that tell us when we should eat for instance you have neurons nerve cells in your gut that signal how stretched or non-stretch the walls of your stomach are right how full or how empty your gut is and send that information to the brain to make you feel to some extent hungry or not hungry in general when our stomach is very full especially if it's very distended even with liquid it suppresses our hunger whereas when our stomach is devoid of that mechanical pressure especially for a number of hours it tends to trigger hunger by signaling via neurons to the brain in addition there are chemical signals that go from the gut to the brain for instance we have neurons in our gut that can detect the presence of amino acids from proteins that we eat fatty acids from the foods that we eat the lipids and sugars different forms of carbohydrate the neurons in our gut are paying attention to or respond to how much amino acid fatty acid and carbohydrate is in our gut and send signals to the brain to either stimulate or suppress hunger so those are chemical signals that are being passed from gut to brain and they work in parallel with the mechanical signals and this idea of in parallel with again is a very common theme in biology especially Neuroscience the term parallel Pathways refers to the fact that anytime there's a critical bodily function it's very unlikely that just one type of information like just mechanical information is going to be used almost always it's going to be mechanical and chemical information I could pick a number of other examples for instance if uh you want to avoid damaging your skin or other tissues of your body which is essential to life well then you have mechanical information about for instance whether or not something is pinching or ready to pierce your skin that's mechanical information it's sent via specific neurons up to the brain to Signal a retraction reflex of you move your limb away from wherever that intense pressure is coming you also have chemical sensing in your skin the presence of things that elicit a burn or that elicit itch or that elicit extreme cold all that chemical information is being signaled up to the brain as well in so parallel Pathways is a common theme so when we're thinking about the respiration aka the breathing system we also need to look at the mechanical system what are the different components of the nose the mouth the lungs Etc that allow oxygen to be brought in and carbon dioxide to be removed from the body but not too much carbon dioxide removed to allow breathing to work as efficiently and as optimally as possible and then we also need to look at the chemical systems of the lungs the bloodstream and how different cells use oxygen and carbon dioxide in order to understand that as well if you can understand the mechanical and chemical aspects of breathing even just at a top Contour well then the various tools that I discussed during today's episode such as the ability to calm yourself down most quickly by doing what's called a physiological sigh I'll go into this in more detail in a little bit but this is two very deep inhales through the nose so the first one is a long inhale and then the second one at after that is a quick sharp inhale to maximally inflate your lungs followed by a full exhale through the mouth to lungs completely empty so it's big inhale through the nose then short inhale through the nose immediately after that in order to maximally inflate the lungs and then a long exhale through the mouth until your lungs are empty you will understand why that particular pattern of breathing and not simply one inhale or not simply an inhale through the nose and an exhale through the nose as well is optimal for reducing your stress quickly that double inhale through the nose followed by a long exhale through the mouth Works to reduce your levels of stress and lower your levels of so-called autonomic arousal very fast in real time and it works better than any other known approach it's not a hack this is actually something that your body has specific neural circuits to do and actually performs during sleep on a PR regular basis and even throughout the day and that you can form voluntarily and it works so well to reduce stress very quickly not because it brings in the maximum amount of oxygen and removes the maximum amount of carbon dioxide but rather because it optimally balances oxygen and carbon dioxide if you understand the mechanical and chemical aspects of breathing then you will understand exactly why that particular pattern of breathing the so-called physiological sigh is the most efficient way to rapidly reduce stress in real time if you can understand the mechanical and chemical aspects of breathing you will also understand why most people are over breathing that is they're breathing too often even if they're breathing in a shallow manner they're breathing too often and they are blowing off or removing too much carbon dioxide and if you understand that carbon dioxide is critical for the way that oxygen is delivered from the bloodstream to the tissues of the body including the brain well then it will make very good sense as to why people who are breathing too much don't actually experience all the effects of elevated oxygen but rather they're putting their body into what's called a hypoxic state they're not getting enough oxygen to the tissues of their body in particular their brain and this is true not just for people who are obese or who suffer from sleep apnea or although that's certainly the case but for people that have believe it or not certain personality types we'll talk about breathing and personality type and actually how breathing has been shown to alter personality that's right breathing can alter personality in positive ways that allow anyone to show up to the various social and non-social Endeavors of their life with more calm more focus alertness and improve their overall health okay so let's talk about the mechanical components of breathing it's really quite simple you've got your nose obviously and you've got your mouth and a little bit later we'll talk about the incredible advantages of being a nasal breather most of the time but also the incredible advantages of using your mouth to breathe both for inhales and exhales during particular types of Endeavors and we'll get back to that a little later but for the meantime the only two ways to bring air into your system are through your nose and through your mouth we also have the larynx which is a rigid tissue or pipe that brings the air from the nose and mouth down to the lungs now that word rigid is really important here because what we will soon learn is that your lungs basically act like a pump you sort of know this already but these are two big bags basically that can fill with air or that can squeeze air out now what most people don't realize is that the lungs are not just two big bags of air your lungs are actually two big bags of air that inside of them have hundreds of millions of little sacks that are called the avioli of the lungs and by having those hundreds of millions of little sacks you increase the surface area of the lungs and by increasing the surface area you allow more oxygen to pass from the air in your lungs into into the bloodstream than if you didn't have those sacks and you allow more carbon dioxide to move from the bloodstream into those sacks of the lungs and then when you exhale the carbon dioxide can be removed okay so those little sacks we call avioli of the lungs are an important part of the mechanical aspect of breathing we'll get to a little bit later okay so at a first pass the mechanical aspects of breathing are really straightforward right you you can breathe through your nose you can breathe through your mouth goes down through the larynx I told you the larynx is a rigid pipe the lungs are not rigid they can expand and they can contract like a pump to bring in air or to expel air now keep in mind that the lungs do not have any muscles themselves so we need muscles that can either squeeze the lungs or that will allow the lungs to expand and there are two general groups of muscles that do that and they are the diaphragm and the so-called intercostal muscles the diaphragm is a thin muscle that sits below the lungs and above the liver and when we inhale provided that we are using what's called diaphragmatic breathing that diaphragm contracts and when it contracts it moves down which allows more space for the lungs to inflate with air now the intercostal muscles are the muscles between our ribs a number of people don't probably don't realize this but your ribs of course are bone but in between those bones you have muscles and the intercostal muscles when you inhale contract and that allows your rib cage to move move up and to expand a bit I think again people probably don't realize that your ribs are not fixed in place they can actually get further and closer apart from one another so when you inhale your rib cage actually moves up sometimes the shoulders will move up as well and that's because those intercostal muscles are Contracting now muscles can't move on their own they are controlled by nerves so we've got the nose the mouth the larynx and the lungs the lungs have all those little avioli in them and as I told we've got the diaphragm as a muscle to move the lungs and we have the intercostal muscles to move the ribs which can allow the lungs to expand again we're just on the mechanical components of breathing but because muscles can't move themselves you should be asking what moves the muscles and it's really nerves that control muscles so whether or not you're Contracting your biceps or you're walking and you're Contracting your quadriceps and your hamstrings and your calf muscles it's neurons nerve cells that control that there's a specialized nerve called the frenic nerve p h r n i c frenic nerve that comes out of the neck and when I say it comes out of the neck what I mean is that there're little neurons that reside in the brain stem in the back of your brain and they send little wires that we call axons down and out of the neck they go close to the heart and a little bit behind it and they go down and they form synapses that is they form connections with with the diaphragm and when those neurons release neurotransmitter which are little chemicals the diaphragm contracts and it moves down so we say that the frenic nerve is a motor nerve it's designed to move muscle however the frenic nerve like a few other nerves in the body is interesting in that it has not just motor nerves in there neurons that control the contraction of muscles it also can sense things there has Sensory neurons so it also sends connections down to the diaphragm and actually down deep into the diaphragm and close to the liver and note that I said liver twice now already and we're going to get back to this later when we talk about physical movement and cramps of the body those Sensory neurons dive deep into the diaphragm and then they go back up to the brain and they allow you to sense where the diaphragm is so they're giving information about where the diaphragm is in your body now most of the time you're not paying attention to this but right now you can actually try this and I would encourage you to do this diaphragmatic breathing is in many ways the ideal way to breathe and that it's the most efficient way to breathe we'll talk about what we mean exactly when we say breathing efficiency later but the diaphragm is designed to allow the lungs to expand or to contract the lungs to bring air into the body or to remove carbon dioxide from the body and if you want to know whether or not you're using diaphragmatic breathing it's very simple if you inhale probably best to do this through the nose but you could do it through the mouth if if you inhale and your belly moves outward on the inhale well then that frenic nerve is controlling your diaphragm properly and then when you exhale your belly should go in just a little bit that's diaphragmatic breathing now diaphragmatic breathing is talked about in the context of yoga it's often talked about as a way to calm down and so on but diaphragmatic breathing is just one mode by which your brain and the frenic nerve can control muscle the diaphragm to control the mechanical aspects of the lungs to bring in air and expel air as I mentioned before you also have these muscles between your ribs or the intercostal muscles and there's a separate set of nerves that allow those muscles to contract and for your rib cage to expand in order to create more room for your lungs to get larger and fill with air or for your rib cage to contract a bit when those muscles relax in order to expel air I'd like to go on record by saying that there is no rule that diaphragmatic breathing is better than breathing where your rib cage moves this is a common misconception people say oh you know if your shoulders are going up and down and your your rib cage is moving while you're breathing well then you're not breathing right and if your belly goes out and uh the rest of your body is still while you breathe well then you're breathing correctly I know of zero in fact zero minus one data to support that statement you have multiple parallel mechanisms to control the mechanics of your lungs and for breathing and when you're exerting yourself very hard you tend to use both the intercostal muscles and your rib cage moving as well as your diaphragm in order to bring in a lot of oxygen and to offload a lot of carbon dioxide and when you're calmer frankly you could use diaphragmatic breathing or you could use rib cage type breathing in order to bring enough oxygen into your system there's no real data showing that diaphragmatic breathing is somehow Better or Worse however being able to mechanically control those independently or to combine them and use them together is of tremendous power toward regul your mental and physical States and we'll talk about how to do that a little bit later for right now please understand that you have these different mechanical components that allow you to bring oxygen into your system and to expel air and to thereby offload carbon dioxide from your system again we haven't talked about the gas exchange of carbon dioxide and oxygen and how that's happening in the bloodstream we'll talk about that next but the basic mechanical components are pretty simple right once again just to review it's nose mouth larynx lung lungs avioli within the lungs and then those two muscles the diaphragm and the intercostal muscles of the ribs one thing I failed to mention is why it's so important that that larynx be rigid that it's a a tube that is very rigid and the reason for that is that unlike the lungs which you want to act as sort of a a Bellow pump where you can you can deflate it and inflate it in order to move air in and out the larynx needs to be rigid so that it doesn't collapse while you're bringing air in and out you can imagine that if it was a very flimsy tube or or the walls of the larynx were very flimsy and thin well then you can imagine breathing in very vigorously and it would shut like a tube uh that suddenly flattens on itself which is would not be good so the fact that the laryn is rigid is actually a very crucial part of this whole system the other important aspect of this system as it relates to the mechanics of breathing is the fact that your nose and your mouth have different resistances to air you can probably notice this right now if you were to for instance breathe in through your mouth and only through your mouth versus breathe in through your nose some of you perhaps have a harder time breathing in through your nose by the way it's perfectly normal that one or the other nostril would be harder to breathe through or easier to breathe through and that that switches across the day has to do with the flow of mucus and cerebral spinal fluid and intracranial pressure totally normal many people out there think they have a deviated septum who don't actually have a deviated septum a little bit later we'll talk about how to repair a deviated septum without Sur surgy because that actually is possible in many not all cases and is immensely beneficial to do but what we know is that breathing in through the nose is a little bit harder and it's supposed to be a little bit harder however because it's a little bit harder because there's more resistance as we say you are actually able to draw more Force into these mechanical aspects of the breathing apparatus and actually bring more air into your lungs okay you can try this right now try breathing in through your mouth to Max maximally inflate your lungs and try and do it through mostly diaphragmatic breathing just for sake of example in other words try and breathe in through your mouth and as you do that have your belly expand and maximally inflate your lungs I'll do it right now with you so that we can do it in uh together and I can prove uh to everyone that um I'm just as deficient in this as you are okay so I can inflate my stomach doing that but now try doing it with your nose and please do exhale before you try doing it with your nose with your nose you're going to feel more resistance but you'll not notice that you can inflate it quite a bit further and you'll feel your entire cavity your your belly and maybe even in your lower back so fill with some pressure so the increased resistance actually allows you to draw more air into the system this turns out to be very important and it also wipes away a common misconception which is if you're somebody who has challenges breathing in through your nose that somehow you should avoid breathing in through your nose actually quite the opposite is true and we can go a step further and say that if you have challenges breathing in through your nose chances are that's because the increased resistance of breathing in through your nose provided it's not completely uded is going to allow you to bring more oxygen into your system this will turn out to be useful later when we explore different techniques for instance not just to calm down quickly but to elevate your energy quickly to uh remove a cramp during exercise and a number of other things that breathing can be used for that can be immensely useful for mental and physical challenges I'd like to take a quick break and acknowledge one of our sponsors athletic greens athletic greens now called ag1 is a vitamin mineral probiotic drink that covers all of your foundational nutritional needs I've been taking athletic green since 2012 so I'm delighted that they're sponsoring the podcast the reason I started taking athletic greens and the reason I still take athletic greens once or usually twice a day is that it gets me the probiotics that I need for gut health our gut is very important it's populated by gut microbiota that communicate with the brain the immune system system and basically all the biological systems of our body to strongly 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cells and without carbon dioxide you're not going to get enough oxygen to the cells and tissues of your body that said if carbon dioxide levels are too high that is very problematic in fact one of the ways that one can reliably induce panic in anybody is to have them breathe air that contains too much carbon dioxide so much so that for people that lack a so-called amydala many of you have probably heard of the amydala this is a brain area that's asso with fear and threat detection even in people who completely lack amygdalas on both sides of the brain because they were removed because they had epileptic seizures there and therefore those people are completely unafraid of things that they ought to be afraid of like heights poisonous snakes any number of different things dangerous to humans well if those people breathe an excess amount of carbon dioxide they immediately have a panic attack what that tells us is that again there are parallel mechanisms there's redundancy in the system to protect ourselves from having too much carbon dioxide in our system so we need enough carbon dioxide and enough oxygen in our system but not too much the way that's accomplished is that of course we breathe in air our lungs inflate and if you recall those little avioli of the lungs those little sacks oxygen can actually move from the air into those little sacks and then from those little sacks into the vasculature the vasculature are the capillary the veins and the arteries of the body because the walls of those little avioli are exceedingly thin and they have tons of little capillaries that go into them and are all around them so this is amazing right there's oxygen literally passing from inside of these little sacks in our lungs because we inhal the oxygen from the air into the bloodstream and then that oxygen gets bound up by proteins in the blood in particular hemoglobin and hemoglobin then delivers oxygen to the very cells and tissues of the body however oxygen can't just hop on hemoglobin and cruise along with hemoglobin until it gets to say your brain and then hop off it doesn't work that way you require carbon dioxide in order to liberate oxygen from hemoglobin carbon dioxide has this incredible property of actually being able to change the shape of hemoglobin hemoglobin is shaped is a sort of a cage around oxygen molecules and when it's in that cage shape the oxygen can't be liberated so you've got oxygen and hemoglobin bound to one another moving through your bloodstream but if a tissue needs oxygen there needs to be carbon dioxide present to open up that cage and that's what carbon dioxide does it allows that cage to change shape and then the oxygen can be liberated and then can be delivered to the tissues whether or not that's brain tissue or muscle tissue so on and so forth and so those are the major chemical components of breathing there are a few other aspects related to the chemical components of breathing such as the fact that carbon dioxide is strongly related to how acidic or how basic your body is in general so for instance if carbon dioxide levels go way down your blood pH goes way up that is you become more alkaline now for many people the word pH and the whole concept of pH immediately starts to evoke anxiety in and of itself um pH is actually very simple you want the body basically to be at a pH of about 7.4 there are some regions of your body in particular along the gut for which that number is importantly different in order for digestion to work properly you've all heard of the gut microbiome the little microbes that provided you have enough of them and they're diverse enough allow your brain and body to function optimally at the level of immune system hormone system brain Etc well in the gut you want the pH sometimes be slightly more acidic because when it's more acidic the little microbiota flourish far more than if it were more basic but basically you want the rest of the body to be at about pH 7.4 if carbon dioxide levels go too low the pH increases in a way that you might say oh well that's bad but that actually allows more oxygen to be available to the tissues of your body at least temporarily we'll talk about this a bit more later if I'm losing any of you just hang in there because we're almost done with this whole business of the mechanics and the chemistry of breathing and then we can get into the tools and revisit some of this later to clean up any misunderstandings that may have Arisen but as we're talking about carbon dioxide over and over again and how key it is to have carbon dioxide and the problems with it going too high or too low you should probably be asking yourself what actually makes carbon dioxide go too low right we know that we breathe in oxygen and then it can pass from the lungs and the avoli into the bloodstream and then we need carbon dioxide to liberate oxygen from the hemoglobin into the cells and tissues of the body and we know that when we exhale or actually I haven't told you this yet but you should know that when you exhale carbon dioxide is actually taken from the bloodstream back into those avioli of the lungs and then when you exhale it's expelled through your mouth or through your nose out into the world so the way I just described all that inhale bring in oxygen exhale expel carbon dioxide pretty straightforward right indeed it is and also tells you that were you to Exhale a lot more or a lot more vigorously you would expel more carbon dioxide and in fact that's exactly the way it works when you hyperventilate of course you are inhaling more than usual but you are also exhaling more than usual so you're of course bringing in more air and oxygen to your body but you're also removing more carbon dioxide from your body than normal carbon dioxide because of the ways that it regulates brain state in fact the way in which it regulates the excitability literally the ability of your neurons to engage electrically or not it can create states of panic and anxiety which is why when you hyperventilate you feel an increase in anxiety or when you feel an increase in anxiety you hyperventilate it's a reciprocal relationship in fact I don't want anyone who has anxiety or who has panic attacks to try this now but for most people it's probably safe as long as you're not driving or doing something mechanical or operating Machinery that is it's probably safe to do 25 or 30 deep inhales and exhales and you'll notice that by about breath 10 you'll start to feel tingly and you'll probably feel a little bit more alert and again if you have anxiety or panic attack Tendencies please don't do this but you will feel an increase in so-called autonomic arousal an increase in the activity of your overall sympathetic nervous system which has nothing to do with sympathy has everything to do with alertness you'll actually deploy adrenaline from your adrenals so I'll just do this now you can try this now again provided you're in a safe place and you don't have anxiety or panic attack Tendencies you will just breathe in through your nose and out through your mouth remember we're breathing in more and more vigorously and we're exhaling more and more vigorously than we normally would it goes something like this now by breath eight or nine or 10 you'll notice that your body starts to heat up that's due to a couple of things U mainly the release of adrenaline from your adrenal I'm already feeling a little bit lightheaded the lightheadedness is actually because your vasculature the capillaries and veins and to some extent even the arteries of your body in particular in your brain are actually starting to constrict so you're cutting off blood flow to the brain why well because carbon dioxide actually is a vasod dilator normally it exists in your body to keep capillaries veins and arteries dilated to allow blood to pass through them when you hyperventilate sure you're bringing in a lot of oxygen which you think would make you more alert and indeed it does but you are also expelling a lot more carbon dioxide than you normally would and that's causing some vasoconstriction and you're going to start feeling tingly in the periphery in your fingers and toes perhaps or your legs you will also notice that you're feeling more alert in the brain but that you might start to feel a bit of anxiety so hyperventilation yes brings in more oxygen also removes more carbon dioxide the removal of excess carbon dioxide puts you into a state that's called hypocapnic all right hypoxia hypoxia is reduced levels of oxygen relative to normal hypocapnia is reduced levels of carbon dioxide relative to normal and it is those reduced levels of carbon dioxide that are largely responsible for that elevation in energy and at the same time a feeling of a bit of anxiety the constriction of the microvasculature in the brain and body and therefore the feelings of being kind of tingly and having kind of an urgency to move okay so by now it should be clear that we need both oxygen and carb carbon dioxide and across the course of this episode I will explain how to adjust those ratios of oxygen to carbon dioxide depending on what your immediate needs are and what you plan to do next whether not that's sleep or exercise or some mental work etc before going any further however there is something I want to touch on because even though not everyone will experience this I think enough people experience it that it is of interest and now's the right time to touch into what happens when you go up to a very high altitude meaning why it's hard to breathe when you get up to high altitudes so if you're close to sea level you are getting kind of the optimal balance of oxygen in the air you breathe as you ascend in altitude so let's say you go to 6,000 ft or 10,000 or maybe even 11,000 ft above sea level or maybe you're one of those rare individuals that climbs denalii or you climb Mount Everest and you get up there and you notice that you know most people are going to wear an ox oygen mask why is it that you need an oxygen mask at those very high altitudes or when people do these very high altitude skydives that they need oxygen uh way up high well a lot of people say oh there's not much oxygen up there you know the air is thinner okay well perhaps a better way to think about it is that remember when we were talking about the mechanical aspects of breathing and the fact that the lungs don't really move themselves that they have the muscles the diaphragm and the intercostal muscles to move them well a lot of the reason why your lungs can fill so readily with air is that when you don't have much air in your lungs there's very low air pressure in your lungs relative to outside you okay so what we mean then is if you were to open up your mouth or your nose and breathe in that is breathe in through your nose or mouth what's going to happen is air is going to move from high pressure to low pressure so it's very easy to fill your lungs even though you need those muscles to move the various things around that allow your lungs to fill the air is going to go from high pressure to low pressure so for those of you listening I just took a big big inhale through my nose and then when you exhale right you're basically taking the lungs from a state in which the pressure is really high in the lungs you know high pressure like a balloon that's full and the pressure in your lungs when your lungs are full is higher than the air outside so it's pretty easy to expel that air through the nose or mouth when you're at high altitudes the air pressure is lower and so what happens is when the air pressure is lower outside your body and your lungs are not full of air you don't have that really steep gradient of high pressure outside the body to low pressure inside your lungs and so you actually have to put a lot more effort into breathing air into your lungs you have to really exert a lot of force you have to get the diaphragm those intercostal muscles working really hard you might even find that your shoulders are lifting with each breath because you really have to generate a lot of force to get enough air and oxygen into your lungs now an important principle to understand is that in humans and in some other species but really what we're talking about now is humans when you inhale that's an active process you really need to use those muscles of the intercostals and the diaphragm in order to inflate the lungs but the whole process is made easier when air pressure outside your body is higher than it is in your lungs because then they're going to fill up really readily exhaling at least for humans is a massive thing you just have to relax the diaphragm and relax the intercostals and let the rib cage kind of fall back to its original position so inhaling is active and exhaling is passive and so what happens is if you're at a high altitude and the air pressure is very low then you have to put a lot of energy into breathing air into your lungs to get an equivalent amount of oxygen into your lungs and then into the bloodstream so that's why when you arrive at a high altitude location for the first few days you're going to feel Li headed maybe a headache you're also going to have more build of carbon dioxide in your system and so the whole balance of oxygen and carbon dioxide is going to be disrupted uh I mention all that because yes indeed there are some changes in the atmospheric gases at high altitudes and uh that can impact how much oxygen you can bring into your system into your tissues but you know I've heard many explanations of why it's hard to breathe or why you feel lousy at altitude well you just discovered one reason which is that you don't have that steep high pressure to low pressure gradient from the outside of the body into the inside of the body the converse is also true if you've been at altitude for a few days and you've had the opportunity to adjust a lot of athletes for instance will go train at altitude it's hard for them in the first days or weeks and then they get really good at training at altitude there are a number of different adaptations that occur in terms of the amount of oxygen that could be carried in the blood by hemoglobin and the interactions between carbon dioxide and hemoglobin and oxygen that allow more oxygen to be delivered to the tissues such that at altitude you can function just normally but if you then move very quickly from altitude say you've been training at 8,000 ft or 10,000 ft you've been hiking up at that high level and you've adapted and you come down to sea level well for about two to 5 days you're going to feel like an absolute Beast you're going to be able to essentially deliver far more oxygen to your muscles per breath in part that is because of the way that the hemoglobin and the oxygen that it's carrying has been altered when you were at high altitude but it's also because when you were at that high altitude those intracostal muscles and those diaphragms got trained up quite a bit and allowed you to generate more air volume for every breath in other words those muscles got stronger and you got more efficient at driving the frenic nerve consciously to really breathe in a lot of oxygen so you don't feel lightheaded headache Etc okay so that's a little bit of an aside but it's an important aside I believe because a it answers a question a lot of people ask and a lot of people wonder about and B because it incorporates both the mechanical aspects of breathing and the chemical aspects of breathing I realize it's a little bit of a unusual circumstance but now if anyone asks you why it's hard to breathe at altitude you know it has to do with this lack of a high pressure to low pressure gradient um across the body and with the the atmosphere outside you it's also an opportunity for me to say that if you do find yourself at altitude and you have a headache or you're feeling like you just can't catch your breath spending some time really consciously trying to draw in larger breaths of air as much as that might seem fatiguing and you'll be short of breath it will allow you to adapt more quickly and a little bit later in the episode we'll touch on a few methods including deliberate hyperventilation combined with some breath holds that can allow you to deliver more oxygen to the cells immediately upon arriving at altitude so you don't get quite as much headache disorientation and so on so leaving breathing at altitude aside let's all come back down to the same conceptual level we can ask ourselves for instance what is healthy breathing and what is unhealthy breathing and the first place we want to tackle this is within the context of sleep so when we go to sleep at night we continue to breathe that's no surprise if we didn't we would die during sleep however there is a large fraction of the population that under breathes during sleep they're not taking deep enough or frequent enough breaths and therefore they are experiencing what's called sleep apnea they are becoming hypoxic hypo oxic there's less oxygen being brought into their system than is necessary people that are carrying excess weight either fat weight or muscle weight or both are more prone to nighttime sleep apnea however there are a lot of people who are not overweight who also experience sleep apnea how do you know if you're experiencing sleep apnea well first of all excessive daytime sleepiness and excessive daytime anxiety combined with daytime sleepiness is one sign that you might be suffering from sleep apnea the other thing is if you happen to snor it's very likely that you are experiencing sleep apnea and I should mention that sleep apnea is a very serious health concern it greatly increases the probability of a cardiovascular event heart attack stroke it is a precursor or sometimes the direct cause of sexual dysfunction in males and females cognitive dysfunction during the daytime it can exacerbate the effects of dementia whether or not it's age related dementia of the normal sort or Alzheimer's type dementia which is an acceleration of age related cognitive decline if you're somebody who's had a traumatic brain injury if you're experiencing a lot of stress sleep apnea is going to greatly disrupt the amount of oxygen brought into your brain and body during sleep and is going to lead to a number of nighttime and daytime issues so it's something that really needs to be addressed and we'll get into this a bit more later but since I raised it as a problem I do want to raise the solution one of the major treatments for sleep apnea is that people will get a CPAP device which is this um face mask and a machine that they'll sleep with and while those can be very effective not everyone needs a CPAP one of the more common methods nowadays that's being used to treat sleep apnea which is purely behavioral in intervention and is essentially zero cost is that people are starting to shift deliberately to nasal breathing during sleep because of the additional resistance of nasal breathing and because of the fact that there's far less tendency if any if any excuse me to snore when nasal breathing taping the mouth shut using medical tape prior to sleep excuse me putting medical tape on the mouth prior to going to sleep and then sleeping all night with medical tape on the mouth is one way that people can learn to nasal breathe during sleep and can greatly offset a lot of sleep apnea snoring and sleep related issues number of people don't want to or don't feel safe putting medical tape on their mouth prior to sleep for some reason they think they're going to suffocate but of course you would wake up if you start to run out of air um at any moment so that's not so much a concern but what they'll do is they will start to use pure nasal breathing during any type of exercise or even just for some period of time walking during the day or while working and again later we'll get into the enormous benefits of Shifting to Pure nasal breathing when not exercising hard meaning at a rate that you could normally hold a conversation although if you're pure nasal breathing you won't be holding that conversation or when simply doing work or um any number of things that are of of low intensity you can train your system to become a better nasal breather during the daytime through these deliberate actions of taping the mouth shut or just being conscious of keeping your mouth shut and that in addition to having a number of positive health and aesthetic effects during the daytime is known to also transfer to nighttime breathing patterns and allow people to become nasal breathers as opposed to mouth breathers during sleep and to snore less and to have less sleep apnea again if you have severe sleep apnea you probably do need to check out a a sleep a CPAP you should talk to your physician but for people who have minor sleep apnea or sleep apnea that's starting to take hold uh these other methods of Shifting to becoming a nasal breather are going to be far more beneficial and far more cost effective than going all the way to the CPAP which by the way doesn't really teach you how to breathe properly as much as it does adjust the air flow going into your system that's an important point that when you shift from mouth to nasal breathing during sleep you're actually learning and training your system to breathe properly and when I say learning and training your system to breathe properly what do I mean let's put some scientific and mechanistic meat on that we already talked about the frenic nerve this nerve that inates the diaphragm and that allows for the lungs to fill up because of the movement of the diaphragm what we didn't talk about however were the brain centers that actually control the frenic nerve and control breathing knowing about these two brain areas and what they do is extremely important not just for understanding the content of this episode but for understanding all of the tools that we'll discuss and indeed your General Health as it relates to respiration so there are basically two areas of the brain that control breathing the first is called the pre-butt singer complex you don't have to worry about the name so much just know that it was named after a bottle of wine and that it was discovered by the great Jack Feldman who's a professor of neuroscience at the University of California Los Angeles this one of the most fundamental discoveries in all of Neuroscience in the last 100 years or more because this brain area that Jack and his colleagues discovered controls all aspects of breathing that are rhythmic that is when inhales follow exhales follow inhales follow exhales that's all controlled by a small set of neurons in this brain stem area so in the around the region of the neck called the pre-butt singer complex and we really owe a debt of gratitude to Jack and his colleagues for discovering that area because it's involved in everything from breathing when we're asleep to breathing when we're not thinking about our breathing it may have a role in that is when its function is disrupted it may cause things like sudden infant death syndrome believe it or not it can explain in large part many of the deaths related to the opioid crisis because exogenous opioids like fenyl and other sorts of drugs which are opioids obviously bind to opioid receptors on that structure and shut it down now keep in mind these neurons are designed to be incredibly robust and are designed to fire inhale exhale inhale exhale no matter if we're awake or aware unaware or asleep to Keep Us Alive exogenous opioids like Fentanyl and drugs that are similar to that can shut down that structure because it's rich with these opioid receptors so it binds to that and it shuts off the preot singer complex which is the major cause of death of people who die from opioid overdoses I think a lot of people don't realize that that think oh the opioids must shut off the brain or shut down the heart no it shuts down breathing so Jack's Discovery no doubt will lead to some important things as it relates to addiction and hopefully I think we frankly can expect that it's also going to eventually lead to ways to prevent death at in people using opioids or other types of drugs Maybe by blocking opioid receptors in pre-ot singer complex using things like now treone Etc in any event pre-butt singer complex is controlling inhale exhale inhale exhale patterns of breathing the other brain Center controlling breathing again through the frenic nerve right it all converges and goes out through the frenic nerve and these intercostal muscles is the so-called parapa nucleus and the paraph facial nucleus is involved in patterns of breathing where there is not an inhale followed by exhale inhale followed by exhale that is it's not rhythmic one than the other but rather where there is a doubling up of inhales or a doubling up of exhales or a deliberate pause in breathing so inhale pause exhale pause inhale pause exhale pause this sort of thing a little bit later we'll talk about a pattern of breathing called box breathing which has a very specific and useful applications in particular for adjusting anxiety and in that case it involves going from rhythmic breathing of inhale inhale inhale exhale that is relying on the pre-butt singer complex neurons to Reliance on the parafacial nucleus neurons and box breathing just to give away what's probably already obvious as you inhale hold exhale hold and repeat and that pattern of breathing even though it's rhythmic in nature because inhales precede exhales precede inhales and so on there's a deliberate breath hold inserted there so anytime we're taking conscious control of our breathing the parap facial nucleus is getting involved now you don't have to assume that the parapa nucleus is the only way in which we take conscious control of our breathing we can also take control of the pre-br singer complex you can do that right now so for instance you are breathing in some specific pattern now that unless you're speaking or eating no doubt is going to involve inhales followed by exhales but you could for instance decide that yes inhales are active and exhales are passive but now you're going to make the exhales active as well so rather than just inhale and then let your lungs deflate you could inhale and then Force the air out that's going to represent a conscious taking over of control of the pre-butt singer complex okay so the reason I'm giving this mechanistic detail is a it's super important if you want to understand all the tools Rel to breathing B it's actually a pretty simple system even though the areas have fancy names like pre-b butting or parap facial it's pretty straightforward right you have one area that controls rhythmic breathing inhale follows exhales and the other area which gets involved in breathing anytime you start doubling up on inhales or exhales in fact the parap facial nucleus is the one that you're relying on while you speak in order to make sure that you still get enough oxygen it's also the one that you will use if you incorporate the physiological sigh or box breathing and frankly most of the time you're using both of these circuits or for these brain systems parap facial and pre-ot singer in parallel again biology loves parallel systems especially for things that are so critical that if we didn't do them we would die like breathing and so it makes sense that we have two different brain structures that control this so now you have an understanding of the mechanical control of breathing that is the different parts within the parts list that are involved in breathing everything from nose to mouth avioli the lungs Etc and the muscles involved in moving the lungs you understand I like to think a bit about bringing oxygen in and removing carbon dioxide but not so much carbon dioxide that you can't actually use the oxygen that you have and you know about two brain centers one controlling rhythmic breathing and one that controls non-rhythmic breathing I want to repeat something that I said a little bit earlier as well which is that breathing is incredible because it represents the interface between conscious and subconscious control over your not just body not just your lungs but that how you breathe influences your brain state so by using your brain consciously to control your breathing you are using your brain to control your brain the best way I've ever heard this described was from a beautiful I should say now classic paper in the Journal of physiology published in 1988 from ballestrino and Sujin where the final line of their summary intro States the brain by regulating breathing controls its own excitability and just to remind those of you that don't remember what excitability is excitability is the Threshold at which a given neuron nerve cell can be active or not so when we breathe a certain way the neurons of our brain are more likely to get engaged they're more likely to be active and when we breathe in other ways our brain becomes harder to activate its excitability is reduced now you might think excitability is a great thing you always want your brain to be excitable but that's actually not the case and in fact that statement that ballestrino anden made led to a number of other investigations that were really important in defining how if people over breathe that is if they hyperventilate at rest they expel that is they exhale too much carbon dioxide what that classic paper by ballestrino and somen led to was a number of different investigations in humans looking at how different patterns of breathing impact the overall state of the brain and the ability of the brain to respond to certain what are called sensory stimuli keep in mind that your brain is always active the neurons are firing at low level low level low level but when you see something or hear something or you want to focus on something or you want to exercise or really listen to something or learn certain circuits in your brain need to be more active than everything else that is there needs to be really high what's called signal to noise there's always a lot of noise and chatter in the background just like the the chatter at a cocktail party or at a stadium event in order to really pay attention focus learn all the incredible things that the brain can do you need that signal to get above the noise there's a beautiful paper that asks how does the pattern of breathing in particular how does over breathing change the patterns of activity in the brain this is a paper entitled effects of voluntary hyperventilation on cortical sensory responses and I will provide a link to the study in the show note captions it's a somewhat complicated paper if you look at all the detailed analyses however the takeaway from this paper is exquisitely simple and I also believe incredibly important basically what it showed is that when people hyperventilate they expel that is they exhale more carbon dioxide than they would normally so they become what's called hypocapnic okay carbon dioxide levels are low in the blood and over a short period of time they become low in the tissues of the body when that carbon dioxide level drops low you would say okay well you're still bringing in a lot of oxygen because they're these people are hyperventilating so they should feel really alert and indeed that's what happens the people feel very alert however because they're not bringing enough carbon dioxide in or rather the proper way to say it would be because they're over breathing exhaling too much they are not retaining or keeping in enough carbon dioxide well then that lack of carbon dioxide means that the oxygen that they are breathing in can't be liberated from the hemoglobin can't get to the brain and what they observe is about a 30 to 40% reduction in the amount of oxygen that's being delivered to the brain and the reduction in carbon dioxide also prevents some of the normal patterns of vasod dilation that the dilating the opening up of the capillaries so again less blood flow but most importantly as it's shown in this paper the brain overall becomes hyper excitable it's as if it's being starved of oxygen and blood flow and all the neurons in a very non-specific Way start increasing their firing level so the background activity is getting louder and louder it's like the rumble or the noise of a crowd at a stadium and as a consequence the sensory input from a sound or from a touch or from some other event in the world doesn't get above the noise what this means is that when we hyperventilate because we aren't retaining enough carbon dioxide we are not getting enough oxygen to the tissues that need oxygen and as a consequence of that the brain becomes hyp excitable we actually know that there's an increase in anxiety and we become less good less efficient at detecting things in our environment so we're not processing information as well at all the noise goes up and the signal goes down again incredibly important set of findings I should also mention that hyperventilation is one way that in the laboratory anyway or in neurosurgery units for some time Physicians would evoke seizure in seizure prone patients the reason that works is exactly the explanation I just gave you seizure is a hyper excitability of the brain not enough inhibition or suppression of the overall circuitry so you get these waves are these storms of electrical activity low levels of carbon dioxide in the brain because of low levels of carbon dioxide in the blood are one of the major triggers for seizures now I realize that most people listening to this are not epileptic but nonetheless this brings us all back to this question of what is normal healthy breathing as I mentioned before normal healthy breathing is breathing about 6 lers of air per minute but of course most of us don't think in terms of liters of air we're not going to go measure our lung capacity at least most of aren't going to do that basically if you are taking relatively shallow breaths and you're just sitting there working or maybe even walking slowly again not talking or engaging in any kind of speech or eating chances are six lers of air per minute is about 12 shallo is breaths and when I say shallow I don't mean you know you know breathing like a little bunny rabbit or something like that I just mean you know casually breathing in out in out the studies that have explored the breathing patterns in large populations of individuals who are not suffering necessarily from any one specific ailment have shown that most people breathe far too much per minute that they're engaging in anywhere from 15 to 20 or even 30 shallow breaths per minute so they are vastly over breathing relative to how they should be breathing now of course if you breathe more deeply so you take a vigorous inhale and then you expel that air well then for to get six liters of air into your system per minute you're probably only going to need somewhere between four and six breaths in order to get that six liters per minute now the total time that it takes to do that inhale and exhale isn't that much longer than a kind of shallow breath provided you're not deliberately breathing quickly during those shallow breaths so then you say well how is it that normal healthy breathing that delivers the appropriate amount of carbon dioxide into the system and doesn't expel doesn't exhale too much carbon dioxide you know how are we supposed to do that normal breathing right are you supposed to breathe four times then hold your breath until the minute passes no what you find is that the correct pattern of breathing is going to involve two things first of all nasal breathing because of the resistance it provides through the nose we talked about earlier is going to deliver more oxygen into your system you're going to be able to generate more air pressure to fill your lungs that greater air pressure is going to take longer to Exhale so already we're increasing the amount of time that each breath is going to take and also what you find is that people that are breathing in the proper healthy manner that is that are balancing oxygen and carbon dioxide in the proper ways are also taking pauses between breaths this is extremely important because even though we have a brain Center the pre-ot singer complex that can control or I should say does control inhale exhale rhythmic breathing those pauses between breaths are not always present in in fact often are not present from people's Baseline breathing patterns and as a consequence they over breathe and as I told you before when people over breathe their brain becomes hyp excitable at the level of the background noise and yet they are less efficient at detecting and learning information we'll get into the specific studies that really illustrate the learning aspect a bit later but they are less efficient at detecting and learning information at focusing and so on as a consequence of this over breathing in the hyperx ability that causes now of course that's also just emphasizing the effects of over breathing and lack of carbon dioxide on the brain there are hundreds if not thousands of studies showing that when we don't have enough carbon dioxide in the tissues of our body that's also problematic for all the tissues the liver the lungs themselves the stomach Etc that relate largely to shifts in PH because of the fact that carbon dioxide strongly regulates the acidity alkalinity of the blood and the tissues that that blood supplies nutrients to including carbon dioxide so the basic takeaway here is you want to breathe in a healthy manner at rest and the best way to do that is to spend some time and it doesn't take much maybe a minute or so each day paying attention to how quickly you are breathing per minute when you are simply at rest when you're making coffee in the morning when you're sitting down to read when you're on social media chronically holding your breath isn't good but neither is over breathing and again every study that is examined the typical patterns of breathing and patterns of breathing that show up as Normal and abnormal has found that more often than not during the nighttime people are under breathing and in the daytime they are over breathing they're hyperventilating I'd like to just take a brief moment and thank one of our podcast sponsors which is insid tracker inside tracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals I've long been a believer in getting regular blood work done for the simple reason that blood work is the only way that you can monitor the markers such as hormone markers lipids metabolic factors Etc that impact your immediate and long-term Health one major challenge with blood workor however is that most of the time it does not come back with any information about what to do in order to move the values for hormones metabolic factors lipids Etc into the ranges that you want with inside tracker changing those values becomes very straightfor forward because it has a personalized dashboard that you can use to address the nutrition-based behavior-based supplement based approaches that you can use in order to move those values into the ranges that are optimal for you Your vitality and your longevity inside tracker now includes a measurement of APO lipoprotein B so-call apob in their ultimate plan apob is a key marker of cardiovascular health and therefore there's extreme value to knowing your apob levels if you'd like to try insid tracker you can go to insid tracker.com huberman to get 20% off any of insid tracker's plans again that's insid tracker.com huberman to get 20% off so next I'd like to address what you can do about your normal patterns of breathing that is how you or anyone can adjust their normal patterns of breathing from an unhealthy to an unhealthy state but the first thing we have to do of course is determine whether or not you're already breathing in an unhealthy or in a healthy way and again when I say healthy or unhealthy I mean are you over breathing are you under breathing Are you delivering the appropriate ratios of oxygen and carbon dioxide to the tissues of your brain and body in order to do this we're going to do a simple test again please don't do this while driving or operating heavy machinery or uh near water of any kind but assuming that you're not doing any of those things I encourage you to sit down certainly not lie down but just sit down I suppose you also could do it standing and we are going to do what's called the carbon dioxide tolerance test the carbon dioxide tolerance test is a sort of backof the envelope measure of how well you are managing carbon dioxide that is how well you can control your breathing at both the mechanical and the chemical level it's a very simple test what you're going to do is for the next 10 seconds or so while I'm speaking you're just going to breathe normally now again and again throughout this episode I'm going to encourage you to be a nasal breather whenever possible but of course there are instances in which you want to engage mouth breathing but for the time being as I continue to blab on for the the next few seconds just inhale through your nose exhale through your nose you don't have to deliberately slow your breathing or increase the Cadence of your breathing however in that time you're also going to want to find some sort of time measuring device like could be your phone or could be a stopwatch what I'm going to ask you to do in a few minutes is I'm going to ask you to inhale through your nose as deeply as you possibly can that is you're going to fill your lungs as much as you can through your nose and then start a timer and measure how long it takes for you to deliberately control that exhale until your lungs are empty okay so this is going to be a controlled exhale through the nose after a big deep breath but for the time being keep breathing at a kind of calm regular Cadence okay so you can find that time measuring device now or you can come back to it later if you like when I say inhale you're going to inhale as deeply as you can through your nose remembering that the diaphragm can really help you here to get a deep inhale by having your belly move out while you inhale and then when I say start you're going to measure the time that it takes to do a complete lungs empty exhale in fact I'll measure it for you uh this will be one of the rare instances in this podcast where um there's going to be a long period of silence as I measure something so I've got a stopwatch here so please prepare to do the big inhale and start inhaling now so inhale as deeply as you can through your nose fill your lungs as much as you can okay now start meaning slowly control the exhale through your nose you're trying to let that air out as slowly as possible and I'm just going to call out every 10 or 15 seconds or so and you want to note when your lungs are empty I know you can hold your breath with your lungs empty that is not an accurate measure 15 seconds it is important that you note when your lungs are empty and that you're trying to control the exhale as much as possible so that you don't arrive at that lungs empty time too quickly I'll explain what too quickly means 30 seconds okay for those of you that have already reached lungs empty please go back to breathing normally for those of you that haven't you can hang in here a little longer if you're still discarding that air 45 seconds and we're rounding toward a minute not quite there some of you are probably still letting out that error I want to point out none of this has to do with cardiovascular fitness level at least not in any kind of direct way and 60 seconds and I realize there will be a small subset of you out there that are still expelling your air in a slow lungs uh slow exhale manner through the nose okay so what we just did is a back of the envelope carbon dioxide discard rate okay if you need to pause this and go back and try it again you just want to time how long it takes you to go from lungs full to lungs empty again with the full understanding I know that you can all sit there like beasts and hold your breath with your lungs empty but please don't do that because that's not going to be informative for what I'm telling you now what I'm going to tell you now is that if it took you 20 seconds or less to expel all your air that is you couldn't extend that exhale longer than 20 seconds in a kind of back of the envelope way we can say that you have a relatively brief or low carbon dioxide Toler okay if it took you somewhere between 25 and 40 maybe 45 seconds to expel all your air that is you could control that exhale for about 45 seconds or 30 seconds then you have a moderate level of carbon dioxide tolerance and if for instance you were able to go 50 seconds or longer for that discard until you hit lungs empty you have a fairly High degree of carbon dioxide tolerance now here's the deal if you had low carbon dioxide tolerance that is your 20 seconds or less you're going to write down the number three okay if you had moderate levels of carbon dioxide tolerance you're going to write down the number five or you could even put five to six and then if you are in that bracket of people that was able to discard your air over a period of 50 seconds or more you're going to write down the number 8 to 10 okay now what are these numbers what are we talking talking about and before we get into what to do with these numbers I want to emphasize again this does not have to do with Fitness level per se I know some worldclass triathletes that have very fast carbon dioxide blowoff times that is their discard rates are 20 seconds or less I should also point out that if you're very stressed that number is going to be very small if you're very relaxed like you just woke up after a long night of sleep and you feel great that number is going to be extended okay so this is a backof the envelope measure that you're going to use each time you decide to do the exercise I'm going to tell you about in a moment and the exercise I'm going to tell you about in a moment can be done every day if you like but what the most interesting studies at least to me indicate is that you could do the exercise I'll tell you about even just once or twice a week and greatly improve your efficiency of breathing and shift yourself away from over breathing when at rest even if you're not thinking about how you're breathing at rest okay so what is this exercise well you just got your number either low medium or high bracket number for carbon di dioxide discard rate remember if you're in the low category your number is three if you're medium it's five to six and if you are in the long carbon dioxide discard rate long duration carbon dioxide discard rate that is 8 to 10 is your number now you're going to do 2 minutes of what most people would call box breathing what is box breathing box breathing are equal duration inhale hold exhale hold repeat so inhale hold exhale hold sounds very easy right how long do you inhale and then hold exhale and then hold well you now know if you are in the low group of carbon dioxide discard rate your inhale is going to be 3 seconds your hold will be 3 seconds your exhale will be 3 seconds and then you repeat 3 seconds so each size of the box if you will is going to be 3 seconds long if you were in the moderate carbon dioxide discard rate category then you're going to inhale for 5 to six seconds hold for five to six exhale for five to six hold for five to six repeat for about 2 minutes you could do 3 minutes if you want but I think it's important to have protocols that are feasible for most people and that's going to mean doing things for about two to five minutes when it comes to these breath Rehabilitation exercises for restoring normal breathing and then of course if you are in the long category of carbon dioxide discard rate you should be able to do an 8 to 10 second inhale 8 to 10 second hold 8 to 10 second exhale 8 to 10 second hold and repeat okay so you could do that exercise now if you like or you could do it at some point offline you can pause this podcast if you want and go try it that's an exercise that you can do for about 2 to three minutes once or twice per week what's happening when you do that exercise well first of all you are greatly increasing your neuromechanical control over the diaphragm this is very important most people are not aware of this frenic nerve pathway in the diaphragm and you're greatly in increasing your mechanical control over this pathway through the process we call neuroplasticity when you deliberately focus on a aspect of your nervous system control in particular nervous system control over musculature that normally is subconscious and you're not paying attention to when you actively take control of that it requires that your brain adjust and rewire the relationship between the different components of that circuit and the wonderful thing is that has been shown to lead to changes in your resting pattern of breathing now why did we go through through the whole business of doing the carbon dioxide tolerance test well for people who don't tolerate carbon dioxide very well they don't have very good frenic that is neuromechanical control of the diaphragm for whatever reason again it doesn't mean you're not fit it just means you don't have or you have not yet developed neuromechanical control of the diaphragm it's would be near impossible for you to do box breathing for 2 or 3 minutes with 8 seconds in 8 seconds hold 8 seconds exhale 8 second hold so that's why we do a a test to see what you're capable of doing you don't want the Box breathing to be too strained where you're where you're really challenged to get around the whole box you want it to be relatively easy because remember you're trying to translate this pattern to your normal pattern of breathing that is your pattern of breathing when you're not consciously thinking about breathing and what are we really translating when we do this box breathing type exercise what you're translating is the ability to pause between breaths and yet take full mechanic driven breaths that involve the frenic nerve and diaphragm so again you're encouraging especially if you use nasal breathing when you do the Box breathing you're encouraging frenic control over the diaphragm and you're getting that six lers of air per minute or so using fewer and fewer breaths over time so this is a again zero cost although it does cost a little bit of time zero cost approach to adjusting your normal pattern of breathing at rest which has a huge number of positive outcomes in terms of your ability to stay relatively calm to not get the hyperexcitability of the brain it has actually been shown in uh various studies we'll talk about one in particular later to greatly improve not just levels of calm and reduce bouts of stress but also improve nighttime sleep there are a huge number of benefits that can come from doing this box breathing exercise but you got to get the duration of the sides of the box right and that's why you do the carbon dioxide tolerance test one thing that many people notice after doing the carbon dioxide tolerance test even just once and then doing this box breathing exercise once or twice a week is that after two or three weeks the Box breathing itself becomes very easy and in that case I recommend taking the carbon dioxide tolerance test over again and almost always what you'll find is that you have been able to extend your carbon dioxide discard rate and therefore you now fall into a different category not just the low or medium but the long carbon dioxide discard rate Cate or and you are able to extend the duration of those inhale hold exhale holds during the Box breathing and of course the ultimate benefit of all this is that it translates to deeper and yet less frequent breathing when at rest and when not consciously paying attention to how you're breathing during the daytime again if at all possible do all of this breathing through the nose for those of you that have a severely uded nose the recommendation always is to breathe through your nose more but I do realize that for some people it's really uncomfortable to breathe through the nose because they have such an included nasal pathway and uh for you folks doing some of this breathing through the mouth can probably uh suffice but if at all possible do the breathing through the nose and um please also let me know how your progress uh evolves over time with the carbon dioxide discard rate and the Box breathing and of course the positive shifts that occur in normal unconscious daytime breathing translate to all the opposite things that we talked about when you are over breathing during the daytime so what I just described in terms of the carbon dioxide tolerance test and the exercise using box breathing to restore normal patterns of breathing and not over breathe and therefore not eliminate too much carbon dioxide is exactly the two tests that were incorporated into a study that my laboratory did in collaboration with our associate chair of Psychiatry at Stanford School of Medicine Dr David Spiegel who's also been a guest on this podcast previously and that study expl box breathing but it also explored other forms of breathing and actually compared those forms of deliberate breathing to meditation as a means to explore what are going to be the minimal effective Doses and most effective ways to chronically reduce stress around the clock and improve mood and improve sleep so the study I'm referring to was just published recently it's entitled brief structured respiration practices enhance mood and reduce physiological arousal we will also provide a link to this paper in the show note captions what this study really focused on was a simple question which is what is the shortest and most effective practice that people can use in order to reduce their levels of stress not just during that breath work practice or meditation practice but Around the Clock 24 hours a day including improvements in sleep and we were excited to do this study because many studies had explored how meditation or in some cases fewer studies had explored how breath work can impact different brain States or bodily States but very few studies had explored how those breath worker meditation practices influenced body brain states around the clock when people were not performing the particular meditation or breath work practice the reason we were able to do this study was really fortunate um the folks over at whoop were generous enough to donate a bunch of whoop straps which allowed us to measure heart rate variability a number of other different physiological parameters we also got subjective reports about people's mood and feelings of well-being we got data about their sleep pinged to us from remote locations so these people rather than being brought to the laboratory and being in a very artificial Circumstance the laboratory as much as we like to think our laboratory is realistic uh we have virtual reality and things like that there's nothing as realistic as the real world and so we were able to have more than 100 subjects out in the real world living their real lives pinging back to us data all the time 4 hours a day so that we could measure how their different interventions that we asked them to do breath work practices or meditation practices were impacting physiological parameters and they were also informing us regularly about their subjective mood Etc we got a lot of data as you can imagine and the basic takeaway from the study was twofold first of all we discovered that deliberate breath work practices done for about five minutes per day across the course of about a month led to Greater reductions in stress than did a five minute a day meditation practice now that is not to say that meditation is not useful in fact there are dozens if not hundreds of papers including one particular I should say particularly beautiful study from Wendy Suzuki's Lab at New York University showing that a daily 10 to 13 minute mindfulness meditation practice can greatly improve focus memory and a number of other things related to cognition and learning however the research on meditation has shown us that meditation at least short meditations mainly lead to improvements in focus and memory not so much reductions in stress although they do lead to reductions in stress what we found was that any number of different breath work practices and we explored three done for five minutes a day outperformed meditation in terms of the ability of breath work to reduce stress Around the Clock compared to meditation the three types of breath work that we explored also showed different effects I should mention the three types of breath work that we compared were box breathing of the sort that you just learned about we compared that to something called cyclic sighing which involves two inhales through the nose to get maximally inflated lungs followed by a long exhale I'll return to that in a moment that was repeated for 5 minutes at a time for each session and a third breath work practice which was cyclic hyperventilation which has the name suggests involves people inhaling deeply through the nose then exhaling passively through the mouth and then repeating inhale through the nose exhale through the mouth repeating that for 25 Cycles one cycle being an inhale and an exhale so that equals one cycle repeating that for 25 Cycles then exhaling all their air and holding their breath with lungs empty for about 15 to 30 seconds and then repeating inhale exhale cyclic hyperventilation for the duration of five minutes okay so people were divided into these different groups either mindfulness meditation where they sat they were not told to control their breathing in any specific way they closed their eyes their focus their attention on a region just behind their forehead one group did that the other group did cyclic sighing another group did box breathing another group did cyclic hyperventilation as any sort of clinical trial like this ought to we then swapped people into different groups so they served as their own control so we could evaluate any kind of between and within individual variability again the a lot of data in this paper but the takeaway was that for the sake of stress reduction around the clock and for the sake of improving sleep and mood the most effective practice of the four practices That We examined was the cyclic sing again cyclic sing is performed the following way you inhale through the nose as deeply as you can then you do a second inhale immediately afterwards to try and maximally inflate the lungs in fact that's what happens we know that during that second inhale even if it's just a very sharp short short inhale the extra physical Vigor that's required to generate that second inhale causes those avioli of the lungs which may have collapsed and indeed in between breaths and often even just through the course of the day and especially if we get stressed those avioli of the lungs start to collapse and because they're damp on the inside they're they have a little bit of fluid they're like a balloon with a little bit of fluid in in the middle it takes a little bit of physical Force to to pop those open now you're not literally exploding them pop but you're reinf lating them with air and then you perform the long exhale through the mouth until lungs are empty so it looks exactly like this now we know that one single physiological sigh of the sort that I just described performed at any time of day under any conditions whether not you're about to walk on stage to give a talk or you're in a meeting and you're feeling stressed or you're in a conversation that's very stressful or you can feel stress mounting because you're in traffic or any number of psychological or physical stressors that may be approaching you or you feel are oppressing you doing one physiological sigh of the sort that I just described is the fastest physiologically verified way that we are aware of to reduce your levels of stress and to reintroduce C that is to shift your autonomic nervous system from a state of heightened levels of autonomic arousal that is sympathetic nervous system as it called is at a higher activation level than the so-called parasympathetic nervous system again sympathetic nervous system having nothing to do with sympathy has everything to do with so-called fight ORF flight although it controls other things too including positive arousal and the parasympathetic nervous system often referred to as the rest and digest system although it does other things too is associated with calming those two things are always in kind of push pull with one another like seesaw or push pull however you want to think about it one physiological side meaning that big deep inhale short second inhale also through the nose and then long exhale to completely lungs empty is known to restore the level of balance in the sympathetic parasympathetic neural circuitries and is the fastest way to reintroduce calm that's one physiological sigh in this study what we asked was that people perform that repeatedly so-called cyclic sign for the duration of five minutes and the people who did that cyclic sighing for 5 minutes a day regardless of the time of day that they did it experienced the greatest reductions in stress not just during the practice but around the 24-hour cycle and it translated again to all sorts of positive subjective changes improvements in sleep lower resting heart rate at all times of day so this is important again this study was not just exploring what happens during meditation or breath work cyclic sighing Etc it was exploring how the changes that occur during that practice translate to changes in breathing and heart rate mood Etc throughout the 24-hour cycle so the takeaway here is twofold first of all if you're somebody who wants to improve your mood and reduce your overall levels of stress and you only have five minutes a day to invest in that hopefully you're doing all the other things like trying to get proper sleep and exercise Social connection nutrition Etc sunlight in the morning of course can't leave that out but if you were going to devote 5 minutes a day to a stress reduction practice that is Now supported by data to translate to reductions and stress Around the Clock the data say that you would want to invest that in cyclic sighing that is double inhale through the nose extended exhale through the mouth until your lungs are empty then repeat for five minutes a day you of course if you like could do meditation it still had positive effects meaning it reduced stress although not as much as cyclic s you could do box breathing if you want for the purpose of reducing stress all the practices we explored did reduce stress but cyclic sighing performed for 5 minutes a day had the most robust and pervasive effect in reducing stress improving mood and improving sleep that's the first message of the study the second takeaway is that one physiological sigh that's right just one physiological sigh where you inhale deeply through the nose another inhale through the nose to maximally inflate the avoli of the lungs and then you exhale to completely lungs empty and then go back to normal breathing is the fastest way to introduce a level of calm and to reduce your overall levels of stress in real time and this is very important I think that out there these days we hear a lot about stress reduction techniques and most all of the stress reduction techniques that have been explored everything from massage to meditation to breath work uh to a hot shower to a foot rub will calm you down the question is do they calm you down just during that practice great if it does but does it also translate to reduced levels of stress at other times in the 24-hour cycle and other positive effects as well so one physiological sigh is a very efficient way to adjust that ratio of sympathetic to parasympathetic activation and immediately bring about calm so it's excellent for realtime control of stress the other thing about physiological size is that it's not a hack it's not the application of a breathing practice to something that it wasn't intended for in fact physiological size were not discovered by me at all they were discovered by physiologists in the 1930s who found that when people under breathe they have a buildup of carbon dioxide in their system and even though carbon dioxide is essential for life you don't want too much of it in your system and that people whether or not they were asleep or awake would engage a physiological size spontaneously subconsciously they would do this double inhale through the nose and extended exhale through the mouth and that did not just eliminate excessive carbon dioxide from the system it also rebalanced the oxygen carbon dioxide ratio in the proper ways in fact it's observed in animal animal you might see this in animals that are tired when animals or humans get tired they tend to start under breathing a little bit and that can often disrupt the balance of carbon dioxide and oxygen and right before a dog will go down for a nap for instance you'll notice that it'll do this double inhale exhale people when they are sleeping if they hold their breath for a period of time which frankly all of us do periodically throughout sleep they will engage a spontaneous physiological sigh during the daytime we are often holding our breath especially nowadays and there's a study on this that we'll talk about a little bit later where when people text message or they're emailing although nowadays people are are mainly on social media and text messaging they often are holding their breath and they will follow a breathhold by a physiological side because during that breathhold they're building up the level of carbon dioxide in their system now mind you I spent you know close to half an hour telling you that most people are over breathing at rest and that's also true but people often will shift from over breathing to under breathing which is a terrible pattern so physiological size done either as a one-off one physiological side to clamp stress or reduce stress in real time or repeatedly over five minutes as a practice that you do each day is going to be not just the most effective way to approach reducing stress around the clock and in real time but also the one that's highly compatible with the way that the neural circuits that control breathing were designed the physiological sigh has some other very useful applications one of the more uh I would say useful ones at least to those of you that exercise is going to be the use of physiological sigh in order to remove the so-called side stitch so if you've ever been running or swimming or exercising you felt a cramp on your right side chances are despite what your High School PE coach told you that raising your arms above your head or drinking less water before you exercise is not going to get rid of that cramp and here's why it's not a cramp at all if you recall the cervical 3 four and five nerves that give rise to the frenic nerve and go down and innervate your diaphragm well as I mentioned before a certain number of those nerve fibers actually course into the diaphragm and go up underneath and if you recall earlier I also said that the diaphragm sits right on top of the liver in other words you actually have sensory innervation of the diaphragm the Deep diaphragm and the liver and there's something called referenced pain which is what people generally experience when they have that side stitch on their right hand side so if you're ever exercising and you feel a cramp on your right hand side it's possible that it's a genuine cramp but more likely is the fact that that frenic nerve sensory inovation is now being carried up to your brain and you are detecting some local or referenced pain in the liver and in the diaphragm now that doesn't necessarily mean you're doing anything wrong although you might not be breathing properly for running at that moment and that's what gave rise to it could be some spasming of the frenic nerve or some inefficient breathing during running we had an entire series on Fitness with Dr Andy Galpin one of those episodes included a lot of information on breathing it was the episode on endurance although breathing was a topic that was thread through multiple episodes in that series you can find that series at huberman lab.com talks a lot about how to breathe during running how to breathe during weightlifting Etc but the point for now is that if ever you're experiencing that right side side stitch I encourage you to perform the physiological sigh and the good news is you can perform it while still running or while still swimming although I suppose with swimming you might have to make some adjustments um because of course you don't want to inhale water or while cycling or any type of activity if you perform that physiological sigh generally two or three times what will occur is that because of changes in the firing of the frenic nerve and in particular because of changes in the sensory feedback from the sensory component of the frenic nerve back to the brain you will experience an alleviation of the pain from that right side side stitch in other words you can get rid of side cramps doing physiological size during activities in particular during running activities now I should also mention that if you're experiencing a side stitch on the left side chances are that has to do with excessive air or fluid in your stomach and there are reasons for that that also have to do with the way that the frenic nerve is it's bilateral and branches to both sides and is catching sensory input put on the left side from some of the local organs and sensory inovation of those organs okay but if you have right side side stitch the physiological side done two or three times while still running ought to relieve that side stitch now as long as we're talking about breathing and the frenic nerve and the relationship between the frenic nerve and your liver and your stomach and some of the other organs in that neighborhood we should talk about the relationship between breathing and heart rate this is an incredibly important topic so much so that I perhaps should have brought it up at the beginning of the episode but nonetheless you now know what your diaphragm does right when you inhale your diaphragm moves down that's right when you contract your diaphragm it moves down it creates space for your lungs to inhale and when you exhale your diaphragm moves up well when you inhale and your diaphragm moves down what happens is there's more space created in the thoracic cavity in particular if you're also breathing deeply and you're using those intracostal muscles to expand your ribs as a consequence the heart actually gets a little bit bigger it's a temporary enlargement in the heart but it's a real enlargement and as a consequence whatever blood is in the heart is now in a larger volume because the heart got bigger and as a consequence that blood is moving more slowly through that larger volume for a short period of time but nonetheless it's moving more slowly your nervous system detects that and sends a neural signal to the heart to speed the heart rate up in other words inhales increase heart rate the opposite is true when you exhale when you exhale your diaphragm moves up your rib cage tends to move inward a bit and you compact the heart you reduce the volume of the heart overall when you reduce the volume of the heart overall blood flow through the heart accelerates because it's a smaller volume so a given unit of blood is move more quickly through that small volume your nervous system detects that and sends a signal to slow the heart down so just as inhal speed the heart up exhales slow your heart rate down now of course even though you can double up on inhales or even triple up on inhales sooner or later if you inhale you're going to have to Exhale all right and the converse is also true of course so what does this mean in terms of controlling your heart rate well let's say you are going in for a blood draw or you're going out on stage and you're stressed well I would encourage you to do a physiological side maybe two physiological size to bring your level of calm up and your level of stress down nonetheless if you have any reason why you want to quickly reduce your heart rate or accelerate your heart rate for sake of physical work output or to calm yourself down additionally not just use the physiological sigh well then you can take advantage of this relationship between inhales and exhales controlling heart rate if you want to increase your heart rate you can simply inhale longer and more vigorously relative to your exhales and if you want to decrease your heart rate well then you're going to make your exhales longer Andor more vigorous than your inhales in fact this process which is called respiratory sinus arhythmia is the basis of what we call heart rate variability heart rate variability involves the vagus nerve the 10th cranial nerve which is a parasympathetic nerve that is associate with a calming aspect of the autonomic nervous system slowing your heart rate down by extending your exhales and it really forms the basis of most all breathing practices if you look at any breathing practices whether or not it's Wim Hof breathing Tumo breathing Kundalini breathing pranama breathing physiological sighing cyclic sighing and on and on and on if you were to measure the ratio of inhales to exhales and the Vigor of inhales to exhales what you would find is that each one would create a net increase or a net decrease in heart rate that could be very accurately predicted by whether or not that breathing practice emphasized inhales emphasized exhales or had those two features inhale and exhale be of equal duration and intensity in fact if you wanted to equilibrate your heart rate what you would do is you would do box breathing because inhale hold exhale hold is by definition creating equal duration inhales and exhales of essentially equivalent Vigor when you do a physiological sigh you're doing two big inhales which is going to speed your heart rate up just a little bit but then a long extended exhale the exhale in the end is much longer than the two inhales even when combined and so you get a net decrease in heart rate the calming effect and and then practices such as Tumo breathing or Wim Hoff breathing or cyclic hyperventilation deep inhales and exhales the inhales are more vigorous compared to the more passive exhales are going to lead to increases in heart rate okay so the relationship between breathing and heart rate is an absolutely lock step one where your heart rate follows your breathing your heart rate and your breathing are in an intimate discussion with one another but where always and forever your inhales increase your heart rate your exhales decrease it now this feature which Physicians call respiratory sinus arhythmia or we sometimes hear about more often nowadays as heart rate variability is something that people in sport have known about for a very long time it's why for instance that marksmen will exhale just prior to taking a shot that's particularly true for people that compete in the biathlon where they CrossCountry ski so their heart rate is up up up up up then they'll get to the point where they actually have to shoot at a Target they'll exhale and then they'll they'll shoot at the Target this is also why for instance if you want to bring your heart rate down very quickly between rounds of martial arts there are a number of different ways to do that but an extended exhale of any kind or frankly any breathing practice that emphasizes exhales is going to bring your heart rate down this has been Incorporated in a number of different contexts including sport military it's also now being Incorporated in a clinical context for people who feel a panic attack coming on I'm very gratified to learn that the physiological sigh is now being explored as a tool to to prevent panic attacks and anxiety attacks this is prior to the panic attack people bringing their heart rate down again through those extended exhales so learning to extend your exhale is really a terrific skill to master and it's a very easy skill to master frankly why do I say a skill well remember what I said earlier which is that humans inhale actively and most typically will passively exhale just let the air drop out of them at whatever rate depending on how much air they inhaled actively exhaling that is actively relaxing the diaphragm and actively relaxing those intercostal muscles of the chest those ones or I should say uh between the ribs is a skill that you can very quickly acquire and will allow you to use that relationship between the frenic nerve the diaphragm the size of the heart the heart volume and all that stuff to really take control of heart rate quickly so that if you feel like your heart is racing too much and frankly a lot of people have a lot of what's called interceptive awareness especially anxious people they can really sense what's going on in their body other people less so like oh my God my heart's beating it's the ready to jump out of my chest and I don't like that I don't like that big long exhale doesn't matter if you do it through the nose or the mouth big long exhale is going to allow you to slow your heart rate down let's talk about hiccups everybody experiences hiccups from time to time I think most people would agree that one hiccup sort of funny two hiccups in a row is really funny and three hiccups in a row is where it starts to be concerning in part because hiccups can be kind of painful and then experience pain in your gut or your lower abdomen and sometimes in your chest as well and it feels kind of intrusive it gets in the way of having conversation or just sitting there and relaxing fortunately there's a simple way to get rid of hiccups and you can arrive at that simple technique if you understand a little bit about what gives rise to hiccups the reason we get hiccups at all is because we experience a spasm of the frenic nerve the frenic nerve as you recall is a nerve that emanates from the cervical region to be specific see 3 four and five those spinal nerves go down of course behind the heart and inate the diaphragm which is the muscle that when it contracts it moves down allows the lungs to fill and then when you relax the diaphragm then the diaphragm moves up and the lungs shrink or they expel air so-called exhalation now the frenic nerve also has that sensory Branch so it's not just involved in controlling the diaphragm at the motor level it's also sensing things deep within the diaphragm and in the liver as well cuz the liver sits right below the diaphragm so a hiccup has that painful Sensation from time to time because there's a rapid sensory feedback or signal rather of a Sharp kind of sensation of contraction within the diaphragm and that's relayed back to the brain and you consciously perceive that as a little bit of pain and then of course the hiccup is the the hiccup which is the spasm the frenic nerve that you experience more less in your throat but all this really is happening along the frenic nerve and toward the diaphragm what this all means is that if you can stop stop the frenic nerve from spasming you can stop hiccups there are a lot of approaches that people have tried to take to eliminate spasming of the frenic nerve you'll hear that you know breathing into a bag which is one way to you know reing EST or reinh Hal carbon dioxide that otherwise would be expelled out into the environment can help that's a very indirect method it rarely Works frankly because it really has to do more with adjusting your breathing to try and adjust the activity of the frenic nerve it's a really roundabout way of trying to uh alleviate hiccups some people will experience relief from drinking from a glass of water from the opposite side of the glasses or have to tilt over at the waist it's a kind of messy approach again it doesn't tend to work a lot of the time for some people it works every time but for most people it doesn't work at all however there is a technique that can reliably eliminate hiccups and it's a technique that takes advantage of hyper Contracting the frenic nerve over a short period of time so that it then subsequently relaxes or alleviates the spasming of the frenic nerve and that simple method is to inhale three times in a row this is a very unusual pattern of breathing but what it involves is taking a big deep inhale through your nose then before you exhale any air take a second inhale through the nose however brief that inhale might be and then a third even micro or millisecond long inhale through your nose to get that third inhale and then hold your breath for about 15 to 20 seconds and then slowly exhale so even though I'm not experiencing any hiccup right now I will demonstrate the method for eliminating hiccups so that you're all clear on how to do it okay here I go okay so it's three inhales all through the no and it is true that that second and third inhale takes some physical effort to really get additional air into the lungs without exhaling first it feels like a the only way I can describe it really is as a sharp second and third inhale because you really have to engage the musculature of those intercostal muscles in the diaphragm in order to do it and then that long exhale can be through the nose or the mouth but I find it particularly relaxing or even Pleasant to do it through the nose this method of three inhales through the nose followed by a long exhale through the nose or mouth will eliminate hiccups right away because what it does is it hyp excites the frenic nerve three times in a row a very unnatural pattern for the frenic nerve to Fire and then it undergoes a hyperpolarization as we call it in which the frenic nerve actually stands a much lower probability of getting activated again for some period of time afterwards so it is important that you try and return to normal Cadence of breathing after doing this three inhales followed by the long exhale if you need to perform it a second time in order to eliminate hiccups because they're simply not going away that's fine you can do that but as far as we know this is the most efficient and science supported way to eliminate hiccups now up until now I've been talking about breathing techniques and I've mainly focus on breathing techniques that emphasize the exhale whether or not it's the carbon dioxide tolerance test whether or not it's cyclic sign or the physiological side that you use in real time to reduce stress one thing that we haven't talked about so much is cyclic hyperventilation cyclic hyperventilation as you recall is a about of 25 or so breaths inhaling deeply through the nose and then passively exhaling or sometimes actively exhaling typically through the mouth so it might look like this that's a very active inhale through the nose and exhale through the mouth it can also be done active inhale through the nose passive exhale through the mouth like so in any event that pattern of breathing repeated for 10 to 25 breaths greatly increases levels of autonomic arousal in fact it's known to deploy adrenaline from the adrenals and in our study we had people then expel all their air so breathe out hold their breath for 15 to 30 seconds and then repeat for a period of five minutes that did lead to some very interesting and positive physiological changes in terms of stress mitigation although not as significant as was observed with cyclic sighing as I talked about earlier now there is a lot of interest in cyclic hyperventilation for sake of for instance extending breath holds this has become popular in part because of the so-call whim Hoff method which is a method that combines breathing cyclic hyperventilation followed by lungs full or lungs empty breath holds depending on which variant of the Wim Hoff method One is using separately and I really want to emphasize separately the Wim Hoff method also involves deliberate cold exposure which as all of you know I'm a big fan of and we've done episodes this podcast on and we have toolkits on deliberate cold exposure for in increasing dopamine levels epinephrine levels immune system function Etc Wim Hoff method also incorporates that and it has a mindfulness component I do want to caution people that anytime you're doing cyclic hyperventilation you want to be very cautious about not doing it in or near water because it does greatly increase the risk of shallow water blackout and that's because when you do cyclic hyperventilation you are expelling you're exhaling more carbon dioxide than usual and what I haven't told you yet is that the trigger to breathe is actually an increase in carbon dioxide what I mean by that is you have a small set of neurons in your brain stem that can detect when carbon dioxide levels in your bloodstream reach a certain level and when they reach that level they trigger the gasp reflex and or the hunger for breathing in other words we don't breathe because we crave oxygen although we do need oxygen of course in order to survive and for our brain to function and our bodily organs to function but our brain is wired such that it has a threat sensor which is carbon diox oide levels are getting too high and that's what triggers the motor reflex to breathe and in some cases gasp for air depending on how starved for air we are so if you do cyclic hyperventilation whether or not it's Wim Hoff method or whether or not it's Tumo method again these things are similar they're not exactly the same there are other breathing methods that incorporate cyclic hyperventilation what you're doing is you're getting rid of a lot of carbon dioxide and therefore you're removing the impulse or lowering the impulse to breathe so that when you enter that breath hold phase after the hypervent ation it's a much longer period of time before you feel the anxiety and the hunger and the impulse to breathe that's one of the real benefits of any technique that incorporates cyclic hyperventilation is that rather than reduce your stress level in real time it actually does the opposite it increases your stress level it increases your levels of autonomic arousal but you're doing it deliberately and then during those breath holds what's happening is you have a lot of adrenaline circulating in your system because of the way that hyperventilation trigger the release of adrenaline from your adrenal glands it also triggers the release of epinephrine which is the same as adrenaline from a little brain area called Locus culus which makes you feel more alert and then during those breath holds and in the subsequent rounds of cyclic hyperventilation people experience what it is to have a lot of adrenaline in their system but they are controlling the release of that adrenaline which is Far and Away different than when life events are triggering that adrenaline so what it really is is a form of self-induced stress inoculation and I do you think there are benefits to practicing cylic hyperventilation because it does allow you to learn how to self- deoy Adrenaline and epinephrine from Locus culus and from the adrenals or I got that backwards adrenaline from your adrenals and epinephrine from Locus cerius and it allows you to explore what it is to maintain calm state of mind and body when you have a lot of adrenaline in your system which certain studies are starting to show can allow people to be able to lean into the stressful aspects of life and let's be honest life is stressful in any event we're all going to experience stress at some point or another and when we do we want to make sure that we're not overtaken by the release of adrenaline from the adrenals that sudden surge of epinephrine from Locus culus so doing cyclic hyperventilation maybe one or two times per week again 25 breaths active inhale passive or active exhale do expect to feel tingly because of that reduction in carbon dioxide from exhaling so much do expect to feel a little bit agitated be very careful doing this if you're somebody who has anxiety attacks or somebody who has panic attacks or disorders of any kind but if you don't and you want to explore this you'll notice you start to feel really ramped up and then during the breath holds which again can be done by exhaling and stopping for some period of time 15 maybe even 60 seconds is a time in which you can explore how to remain mentally calm some people even choose to do math problems or think of things in a kind of structured way while they have a lot of these hormone neurotransmitters circulating at High high levels in their system in other words as a way to learn to manage your mind and body under conditions of stress now if you are somebody who's using deliberate cold exposure either cold showers or ice baz or cold immersion I often get asked how best to breathe during those different types of activities really there's no best way to breathe although if you wanted to turn those activities into their own form of stress inoculation again please don't use cyclic hyperventilation that's dangerous I don't recommend it whatsoever but you can try to actively slow your breathing that is to make sure that you're engaging in rhythmic breathing now up until now I've said that rhythmic breathing is the default pre-ot singer nucleus controlling rhythmic breathing is the default and that doubling up on inhales and exhales is something that happens when you deliberately take over the action of preut Syer complex now that's true 99% of the time however there are certain conditions such as conditions of heightened state of emotional arousal right if you think about somebody who's been crying oftentimes they'll do the double inhale exhale that says or triple inhales or if somebody's very very afraid it's all inhales okay so it does sometimes happen spontaneously actually when we get into very cold water there's a very robust decrease in the activation of the prefrontal cortex which is the area of brain real estate right behind the forehead that controls structured thinking your ability to reason and make sense of what's going on if you get into really cold water you should not expect that brain region to work or at least not work very well at all for the first 20 or 30 seconds that you're in the cold water from the time you get into cold water because here we're talking about deliberate cold exposure I encourage you to try and control your breathing and make it rhythmic that is inhales follow exhales follow inhales follow exhales even if they have to be fast inhale exhale inhale exhale why because the default when we get into a stressful circumstance emotionally or physically stressful circumstance is that rhythmic breathing stops and that parapa nucleus takes over and it's and it's that kind of panicky mode and by simply controlling our breath again even if it's fast from inhale to Exhale and making sure that we're alternating inhales and exhales rhythmically and what you'll find is that you'll be able to navigate that what would otherwise be a very stressful circumstance and make it less stressful or maybe even Pleasant and that skill definitely translates to other as ects of life in which you know you're hit Square in the face with something stressful you'll notice your breathing and your pattern of breathing switching to multiple inhales or you know a breath holding essentially departing from rhythmic breathing and by quickly returning to rhythmic breathing and maybe even trying to slow the breathing and extend those exhales you'll find that you can very quickly calm down next I'd like to discuss what I find to be an absolutely fascinating topic it's also one that's highly useful in the world which is how your specific patterns of breathing relate to your ability to learn and to remember information how it can modulate fear and a number of other aspects of how your brain functions this is a literature that's been reviewed recently in a lot of Exquisite detail uh in a beautiful review by Jack Feldman who I mentioned earlier one of the pioneers of the Neuroscience of breathing the title of the review is breathing Rhythm and pattern and their influence on emotion again we'll provide a link to this review in the show note captions this review includes discussion of several studies one in particular that I'll um get into in a bit of detail that describes the following right now I just want you to breathe regularly meaning rhythmically you can inhale and exhale through your mouth or through your nose I'd prefer that you do it through your nose because nasal breathing unless you need to breathe through your mouth because of Hard Exercise or eating or talking is always going to be the better way to go nasal breathing improves the aesthetic of your face that's been shown we'll talk about that just briefly in a few minutes nasal breathing improves the amount of oxygen you can bring into your system etc etc okay so just breathe inhale exhale inhale exhale and know that during your exhales your pupil that is the pupil of your eye is getting bigger and as you exhale it's getting smaller in addition when you inhale your reaction time to anything that happens around you a car swerving in front of you something that you might detect in the periphery of your VIs Vision or here off in the distance increases significantly compared to when you're exhaling in addition when you are inhaling your ability to remember things especially things that take a bit of effort to remember and your ability to learn new information is significantly greater than it is when you're exhaling now as you hear all that you're probably thinking okay how do I just inhale well of course that's not going to be the best approach you need to Exhale as well for all the reasons you now are well aware of but what these findings really illustrate and I should mention these findings are all carried out in humans all right so these are relate to some stuff in animal studies but what I just described has been shown in human studies consistently when we inhale and in particular when we inhale through our nose our brain is not functioning in the same way as when we exhale now that doesn't mean that our brain is functioning in a deficient way when we exhale it just doesn't function as well as it relates to memory retrieval memory formation and some other aspects of cognition now you might be asking why in the world would this be well I wasn't consulted at the design phase and anyone that tells you that they were you should back away from quickly but one reasonable explanation for why our brain functions better at least in the context of what I just talked about when we inhale is because the old factory system is actually the most ancient sensory system of all the sensory systems we have so before Vision before audition before touch before all of that the olfactory system is the most ancient system and the olfactory system of course is designed to detect chemicals in the environment and so if you imagine an early organism that perhaps we evolved from or perhaps we didn't but nonetheless that we share some features of at least in terms of olfactory function in order to get that chemical information into the brain we need to inhale you need to bring that information in now for aquatic animals they could take it in through water but for animals that are terrestrial that live on land they would have to get it through the air so inhalation we know activates certain regions of the so-call pform cortex these are areas of the neocortex that are more ancient as well as increasing the activity of brain areas such as the hippocampus which is a brain area involved in learning and memory in fact one of the studies that illustrates this most beautifully is a study that was published in the Journal of Neuroscience um in 2016 by the way Journal Neuroscience is a very fine journal and the title of this paper is nasal respiration entrains human lyic oscillations and modulates cognitive function this is a paper that followed up on an earlier paper that showed that when people breathe in through their nose their recognition and their discrimination of different odors was far greater than when they breathed in through their mouth now that result was interesting but it was also sort of a duh because you smell things with your nose not your mouth you taste things with your mouth and you speak with your mouth mouth and there a bunch of other things you can do with your mouth but nonetheless that study pointed to the idea that the brain is different during nasal inhalations versus nasal exhalations versus mouth inhalations versus exhalations what it basically showed is that the brain ramps up its levels of activity and that signal noise that we talked about earlier if you recall that ability for the brain to detect things in the environment is increased during inhalation but because that earlier study focused on smell on Old faction it was there was a bit of a confound there it was hard to separate out the variables so this paper the one I just mentioned nasal respiration and transhuman limic oscillations and modulat cognitive function did not look at detection of odors rather it looked at things like reaction time or fear and basically what it found is that reaction time is greatly reduced when people are inhaling so they had people look at fearful stimula they at their reaction time to fearful stimuli in other words their ability to detect certain kinds of stimuli and they were given a lot of different kinds of stimuli so they had to you be able to discriminate between one sort of oops excuse me one by the way folks for those listening I just bumped the microphone getting rather animated here what these subjects had to do was detect one type of stimulus versus another stimulus that they were being exposed to and what they found is if people were inhaling as that fear inducing stimulus was presented their reaction time to notice it was much much faster and they related that to patterns of brain activity and they were able to do that because they were actually recording from the brain directly from beneath the skull and they were able to do that because they had some patients that had intracranial electrodes embedded in their brain for sake of trying to detect epileptic seizures so you know there's a lot to this study and a lot that we could discuss but the basic takeaway is that when people are inhaling that is when they're drawing air in through their nose in particular their abil ability to detect what's going on in the world around them is greatly enhanced and not just for fear but also for surprise of All Sorts so when people are inhaling their ability to detect novel stimuli things that are unexpected or that are unusual in their environment is significantly increased again we'll put a link to this study as well I find it to be one of the more interesting studies in this realm although there are now many additional studies that support this statement that I made earlier which is that during inhal also called inspiration there are a number of very fast physiological changes such as changes in pupil diameter changes in the activity of the hippocampus this memory encoding and retrieval area of the brain and other areas of the brain so what's the tool takeaway from this if you are sitting down to read or research or study or you really want to learn some information maybe you're listening to a podcast or some other sorts of information that you want to retain it actually makes sense to increase the duration or the intensity of your inhales as you do that the more that you're inhaling relative to exhaling in terms of duration the more that your brain is in this focused mode and this mode of being able to access and retrieve in information better now there's one caveat to this that I think is important because I know a number of people listen to this podcast for sake of gleaning tools not just for cognitive enhancement but for physical enhancement it turns out that when you are inhaling air you're actually less able or I should say less efficient at generating voluntary movements now that might come as a surprise you know up until now we've basically been talking about inhalation is great almost to the point where you wonder like is exhalation good for anything right you don't want to over breathe and kick out too much carbon dioxide well of course exhalation is great for things in fact if you're somebody that's played baseball or softball what are you told that you should exhale on the swing to generate the maximum amount of power if you're somebody who has done martial arts of any kind traditional Western boxing as you strike that's where people typically do the the the ha L the sort of classic karate type thing that's more of a movie thing I don't know whether or not people actually use the Haya but in boxing often times people will do the sh you know they'll do a rapid exhalation a forceful ex exhalation keeping in mind again that inhales typically are active they engage the diaphragmatic muscle they engage those intercostal muscles whereas exhales tend to be passive unless we take active control of the exhale and indeed our ability to generate fast directed so-called volitional voluntary movements is greatly enhanced if we do them during the exhale not the inhale now with all of that said I haven't yet really talked about mouth versus nasal breathing and it really can be a fairly short discussion because what abundant data now show and has been beautifully described in the book called Jaws a hidden epidemic this is a book that was written by Paul and Sandra Khan my colleagues at Stanford School of Medicine it has an introduction and a forward from Jared diamond and from the great Robert sapolsky so some real Heavy Hitters on this book what that book really describes is that whenever possible meaning unless you're speaking or eating or you're exercising or other activities require some change in your pattern of breathing we should really all be striving to breathe through our nose not through our mouth and that relates to the increased resistance to breathing through the nose we talked about earlier again I'll say it a third time time that increased resistance through the nose allows you to inflate your lungs more not less the other thing that breathing through your nose allows you to do is it both warms and moisturizes the air that you bring into your lungs which is more favorable for lung Health than breathing through the mouth hard breathing through the mouth or simply mouth breathing at all is actually quite damaging or can be I should say quite damaging to some of the respiratory functions of your lungs that of course does not mean that you shouldn't breathe hard through your mouth when you're running or sprinting or exercising hard but you don't want want mouth breathing to be The Chronic default pattern that you follow nasal breathing is the best pattern of breathing to follow as a default State another aspect of nasal breathing that's really beneficial is that the gas nitric oxide is actually created in the nasal passages it's a gas that can cause relaxation of the smooth muscles that relate to the vasculature not just of your nose but of your brain and for all the tissues of your body this is why nasal breathing and not mouth breathing is great for when you want to relieve congestion so a lot of these things seem counterintuitive right your nose is stuff so uh that mainly makes people breathe through their mouth but turns out that breathing through your nose will allow some dilation of the vasculature more blood flow dilation of the nasal passages and delivery of nitric oxide to all the tissues of your body and that dilation of the small capillaries that innervate essentially every organ of your body allow the delivery of more nutrients and the removal of carbon dioxide and other waste products from those tissues more readily than if you're not getting enough uh excuse me nitric oxide into your system okay so a lot of reasons to be a nasal breather if you want to check out that book Jaws hidden epidemic it's a terrific read and it also shows some absolutely striking pictures twin studies and so forth and some before and afters of people and the aesthetic changes that they experienc when they shifted from being a mouth breather to a nose breather these are striking examples that have been observed over and over over again when people mouth breathe there's an an elongation of the jaw droopiness of the of the eyelids and the entire jaw structure really changes in ways that are not aesthetically favorable fortunately when people switch to becoming nasal breathers and of course that takes some encouragement either by mouth taping or doing their cardiovascular exercise with mouth closed or by doing the sorts of exercises that we talked about earlier when they switch to becoming nasal breathers by default the aesthetic changes that occur are very dramatic and very favorable including you know sort of elevation of of the eyebrows not not in an artificial sense or a kind of outrageous way but elevation of the cheekbones sharpening of the jaw and most notably improvements of the teeth and the entire jaw structure in fact one simple test of whether or not you can be an efficient nasal breather and whether or not you've been nasal breathing efficiently or most of the time in the past or whether or not you've been relying more on mouth breathing that was described in the book Jaws is you should be able to close your mouth and breathe only through your nose again this is at rest not during exercise necessarily you might do it during exercise but close your mouth put your tongue on the roof of your mouth and it should fit behind your teeth and you should be able to nose breathe in that position many people won't be able to do that but fortunately as I mentioned earlier if you nasal breathe that is you deliberately nasal breathe when at rest for some period of time you will experience an increased ability to nasal breathe and you should also experience some addition of space within the pallet of your mouth to allow your tongue to sit more completely on the roof of your mouth this is especially true for children that perform this technique again I refer you to the book Jaws a hidden epidemic it's an absolutely spectacular book you can also just um look online before and after Jaws hidden epidemic and look at some of the changes in facial structure that occur when people move from mouth to nasal breathing and it's really quite striking so during today's episode per always we covered a lot of information first we talked about the mechanical aspects of breathing the lungs the diaphragm the trachea and so forth we also talked about the chemical aspects of breathing that really breathing is a way that we bring oxygen to our cell and that we get the correct levels or I should say we maintain the correct levels of carbon dioxide in our system neither too much nor too little in order to allow oxygen to do its magic and to allow carbon dioxide to do its magic because as you learned during today's episode carbon dioxide is not just a waste byproduct it has very critical physiological functions you need to have enough of it around and therefore you don't want to over breathe especially at rest we talked about a tool to measure how well you manage carbon dioxide the so-called carbon dioxide tolerance test and various exercises that you can use simply by breathing to decrease your stress in real time decrease your stress chronically Around the Clock obviously that's a good thing improve sleep improve mood how to increase breathhold times and why you might want to do that also how to eliminate hiccups we talked about how to breathe in order to eliminate the side stitch or side cramp that you might experience during exercise and how to breathe in order to improve learning and memory reaction time and various other aspects of cognitive and physical function I do realize it's a lot of information but as always I try and give you information that is clear hopefully interesting as well and actionable toward a number of different end points so if you're someone body that's just now starting to think about the application of breath work I would encourage you to please yes do the carbon dioxide tolerance test that we'll give you some window into how well or how poorly you're managing breathing and then here's the great news the great news is that breath work that is deliberate respiration practices are very effective at creating change very quickly in some cases such as the use of the physiological sigh or cyclic hyperventilation those changes can be experienced the first time and every time because again these are not hacks these are aspects of your breathing apparati including the mechanical stuff and the neural stuff and the gas exchange stuff all of which you were born with and that are available to you at any moment so all you really have to do is explore them and deploy them as you 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at hubman lab.com for you to explore once again I'd like to thank you for today's discussion all about the biology and application of breathing and last but certainly not least thank you for your interest in science [Music]